Daily Trust (Abuja)

14 October 2011

Nigeria: No Appointment System for Pregnant Women in FCT

Pregnant women are yet to start attending antenatal care on rigid appointment schedules, investigations have revealed. Instead, they still receive care on "first-come-first-served" basis, some women have disclosed.

Until now, women still visit hospital at mostly their own time. The revelation came after doctors raised concerns that regulated appointment for hospital visits was not feasible yet because of continued patient apathy.

The initial move called for a computerised patient appointment system, said Dr Muhammadu Mai, general manager of FCT Hospital Management Board, which manages all district hospitals of the FCT.

In it, hospital clinic time was to be chopped up into time bands of two to three hours, with half-hour intervals, to accommodate patients in groups of 30 or 40. Women not given appointment in the time band had no reason to be in hospital for the day.

Weeks after, with the system yet to be implemented, hospital authorities said the proposed appointment system could not be operational because patients were failing to keep to appointment.

Women attending clinic have confirmed that a computerised appointment system is still way off. The current system allocates special clinic days for pregnant. Past investigations have shown women arriving at hospital as early as six in the morning. Even hospital staff registering patients on their first day advise women to report as early as possible for their first clinic day. And some women have been seen spending the night at hospital.

While the number of those spending nights in hospital in order to see their doctors quicker has reduced, the early rush on clinic days is yet to abate.

With as many women booked for clinic on one day, the system is based on "first come, first served," one woman told Daily Trust.

Heavily pregnant, she had already been at Maitama District Hospital for three hours on a Tuesday clinic day.

"You can come at ten o'clock, but you are on your own."

She added that though patients were free to come anytime they wished, they were attended to only when their turns came, if ever it did.

Compelled or not

Women spoken to are quick to insist they are under no physical compulsion to arrive at six but have no choice since that means seeing their doctors early.

But doctors are forced to make exceptions sometimes, another respondent gave her name as simply Mrs Agbo said.

"There was a woman coming for the first time, without registering. She was allowed to see the doctor. She just pleaded, because she was heavily pregnant," she said in pidgin.

Chief medical director of Wuse District Hospital, Dr Tayo Daramola, in a recent interview, explained that clinic day at his hospital was allotted for Fridays to allow healthworkers attend to gynaecological, surgical and other needs of patients.

It points to staffing problems for hospitals that are hoped to be standards in healthcare for the country's capital. The HMB is taking on at least 700 medical personnel to be deployed to Abuja hospitals, according to Dr Mai, meaning more hands in districts hospitals in Gwarimpa, Kubwa, Nyanya, Bwari, Kwali, Karshi, Abaji, Rubushi, and Kuje.

Despite pushing personnel and equipment to hospitals on the outskirts, Maitama and Wuse, especially, remain congested with patients every day, including many outpatients.

However, women arriving for antenatal care are confident they are getting the best from their doctor.

"If you have seen your doctor, you don't need anything else," said a pregnant patient at Maitama hospital.

Her fellow patient said assessing quality of care is one reason why nurses tell patients to come with their husbands. "If you can come with your wife, then come along," she advised.

With a baby nursing at her breast, she proudly declared that all her children were born at Wuse General. She refuses to be drawn on whether her own husband attended clinic with her, but says there are advantages to having a husband tag along.

"Sometimes, there may be things your wife may not understand. But you might understand it."

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